Objective: We aimed to investigate associations of striatal dopamine uptake and various non-motor symptoms in non-demented patients with Parkinson’s disease (PD).

Background: Dopamine transporter (DAT) scans in patients with PD showed significant correlations of dopamine depletion and motor deficits, suggesting in vivo dopaminergic imaging technology may reflect the amount of dopaminergic neuronal loss. Recently, some researchers studied whether which non-motor symptoms including depression, anxiety were related to dopamine deficits in the striatum [1-6]. However, the previous studies assessed only a few number of non-motor symptoms.

Method: PD patients who underwent both brain magnetic resonance imaging and 18[F]-FP-CIT PET in our hospital were included after reviewing their medical charts. PD was diagnosed according to the UK Brain Bank Criteria. Moreover, we only enrolled patients with the typical pattern of dopaminergic depletion on 18[F]-FP-CIT PET scans [7] to rule out other atypical parkinsonism. We excluded patients below 24-point score on the Mini-Mental State Examination (MMSE) indicating dementia. Following screening, 30 patients with non-demented PD were enrolled in the study. The striatum was divided into 12 subregions, and DAT activity, as striatal dopaminergic concentration, was calculated in each subregion. In addition to measuring motor symptoms using the Unified Parkinson’s Disease Rating Scale-part III (UPDRS-III), various non-motor symptoms were assessed using the Montreal cognitive assessment, Frontal assessment battery, Beck depression inventory (BDI), Beck anxiety inventory, PD sleep scale (PDSS), PD fatigue scale, and Non-motor symptoms scale (NMSS) for PD.

Results: For simple linear regression analyses, as expected, dopamine loss in several striatal subregions including bilaterally anterior and posterior putamen was negatively related to the UPDRS-III score. However, striatal dopaminergic depletion in the 12 striatal subregions was not correlated with any of the non-motor symptoms.

Conclusion: Various non-motor symptoms were not associated with striatal dopaminergic deficits in non-demented patients with PD, inferring that non-dopaminergic systems play an important role in the pathogenesis of non-motor symptoms in patients with PD. Further well-designed studies are required to validate our results.

References: [1] Weintraub D, Newberg AB, Cary MS, Siderowf AD, Moberg PJ, Kleiner-Fisman G, Duda JE, Stern MB, Mozley D, Katz IR. Striatal dopamine transporter imaging correlates with anxiety and depression symptoms in Parkinson’s disease. J Nucl Med 2005 46(2):227-232 [2] Erro R, Pappata S, Amboni M, Vicidomini C, Longo K, Santangelo G, Picillo M, Vitale C, Moccia M, Giordano F, Brunetti A, Pellecchia MT, Salvatore M, Barone P. Anxiety is associated with striatal dopamine transporter availability in newly diagnosed untreated Parkinson’s disease patients. Parkinsonism Relat Disord 2012 18(9):1034-1038 [3] Ceravolo R, Frosini D, Poletti M, Kiferle L, Pagni C, Mazzucchi S, Volterrani D, Bonuccelli U. Mild affective symptoms in de novo Parkinson’s disease patients: relationship with dopaminergic dysfunction. Eur J Neurol 2013 20(3):480-485 [4] Vriend C, Raijmakers P, Veltman DJ, van Dijk KD, van der Werf YD, Foncke EM, Smit JH, Berendse HW, van den Heuvel OA. Depressive symptoms in Parkinson’s disease are related to reduced [123I]FP-CIT binding in the caudate nucleus. J Neurol Neurosurg Psychiatry 2014 85(2):159-164 [5] Felicio AC, Moriyama TS, Godeiro-Junior C, Shih MC, Hoexter MQ, Borges V, Silva SM, Amaro-Junior E, Andrade LA, Ferraz HB, Bressan RA. Higher dopamine transporter density in Parkinson’s disease patients with depression. Psychopharmacology (Berl) 2010 211(1):27-31 [6] Rektorova I, Srovnalova H, Kubikova R, Prasek J. Striatal dopamine transporter imaging correlates with depressive symptoms and tower of London task performance in Parkinson’s disease. Mov Disord 2008 23(11):1580-1587 [7] Oh M, Kim JS, Kim JY, Shin KH, Park SH, Kim HO, Moon DH, Oh SJ, Chung SJ, Lee CS. Subregional patterns of preferential striatal dopamine transporter loss differ in Parkinson disease, progressive supranuclear palsy, and multiple-system atrophy. J Nucl Med 2012 53(3):399-406

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MDS Abstracts - https://www.mdsabstracts.org/abstract/relationship-between-striatal-dopamine-depletion-and-various-non-motor-symptoms-in-non-demented-patients-with-parkinsons-disease-a-pilot-study/